Attention: Extra-hepatic manifestation of hepatitis C virus infection

Jan 16, 2008

In 1994, the team of Tchernev and Petrova from Alexandrovska Hospital in Sofia examined a female patient with liver cirrhosis caused by chronic Hepatitis C virus (HCV). They were intrigued by the patient's many extra-hepatic manifestations -- vascular lesions on the lower limbs, acute pain in the joints, intense tingling of the fingers, and extreme labor-impairing fatigue.

They were also intrigued by the presence of cryoglobulins in the patient's blood. Two years later, the patient developed enlarged lymph nodes on the neck. When one of the nodes was histologically tested, the patient was found to have lymphoma.

This case spurred the interest of the investigators in the extra-hepatic manifestations and complications of HCV infection, and for over a decade they studied the links between HCV infection, cryoglobulinemia, and lymphoma.

A research article published on December 28, 2007 in the World Journal of Gastroenterology addresses this problem. In a study of 136 Bulgarian patients with HCV, the team of Tchernev and Petrova found 76.5% of the patients had extra-hepatic manifestations. Common manifestations were fatigue (59.6%), renal impairment (25%), type 2 diabetes (22.8%), paresthesia (19.9%), arthralgia (18.4%), and purpura predominantly of the lower limbs (17.6%). Over 37% of the patients had cryoglobulins, and 8.8% had B-cell lymphoma.

The study found positive links between the presence of extra-hepatic manifestations and age, female gender, duration of the infection, infection by transfusion of blood and blood products, and extensive liver fibrosis. Therefore, elderly women with chronic HCV and advanced liver fibrosis, who were infected by transfusion during childbirth, are at the highest risk of developing extra-hepatic manifestations of HCV infection.

The study also showed most extra-hepatic manifestations of HCV infection are associated with the presence of cryoglobulins. In particular, the risks of developing B-cell non-Hodgkin lymphoma are much higher in cryoglobulin-positive than in cryoglobulin-negative patients. In the study, 17.6% of cryoglobulin-positive patients had lymphoma, whereas only 3.5% of cryoglobulin-negative patients did.

Given the prevalence of HCV around the world, it is important for physicians to recognize the extra-hepatic signs and symptoms of HCV infection. Patients who exhibit such manifestations should be tested for HCV infection. This can lead to prompt diagnosis and effective treatment of the infection before the development of cryoglobulinemia, when treatment gives poor results or is ineffective.

Source: World Journal of Gastroenterology

Explore further: Study finds acupuncture does not improve chronic knee pain

add to favorites email to friend print save as pdf

Related Stories

Group: Wildlife populations down drastically

23 hours ago

Populations of about 3,000 species of wildlife around the world have plummeted far worse than previously thought, according to a new study by one of the world's biggest environmental groups.

Ultrafast remote switching of light emission

1 hour ago

Researchers from Eindhoven University of Technology can now for the first time remotely control a miniature light source at timescales of 200 trillionth of a second. They published the results on Sept. 2014 ...

Microsoft skips Windows 9 to emphasize advances

1 hour ago

The next version of Microsoft's flagship operating system will be called Windows 10, as the company skips version 9 to emphasize advances it is making toward a world centered on mobile devices and Internet ...

Recommended for you

Ebola case stokes concerns for Liberians in Texas

23 minutes ago

The first case of Ebola diagnosed in the U.S. has been confirmed in a man who recently traveled from Liberia to Dallas, sending chills through the area's West African community whose leaders urged caution ...

Is Australia prepared for Ebola?

3 hours ago

Australia needs to be proactive about potential disease outbreaks like Ebola and establish a national centre for disease control.

Dallas hospital confirms first Ebola case in US

9 hours ago

A patient at a Dallas hospital has tested positive for Ebola, the first case of the disease to be diagnosed in the United States, federal health officials announced Tuesday.

First case of Ebola diagnosed in US

10 hours ago

The United States has diagnosed its first case of the deadly Ebola virus in a man who became infected in Liberia and traveled to Texas, US health officials said Tuesday.

User comments : 0